Search results for: sustainability outcomes

Authors: Shannon Rappe, Elizabeth Morse, David Phillippi

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Postpartum women with an opioid use disorder (OUD) are at high risk for treatment disengagement, leaving them vulnerable to overdose and death between seven and twelve months postpartum. Intensive case management programs have been proposed as an effective strategy to reduce barriers and increase treatment engagement among postpartum women. The purpose of this project is to determine the effects of early engagement in an intensive case management program on postpartum engagement and infant health outcomes among postpartum women with opioid use. This retrospective review of secondary data was collected on 225 infants, and 221 postpartum women enrolled in an intensive case management program in Tennessee between May 1, 2019, and May 5, 2020. Chi-squares were computed to examine the timing of engagement during pregnancy, maternal treatment outcomes, and infant health outcomes, including neonatal abstinence syndrome (NAS), birth weight, gestational age, and length of stay. The mean prenatal program engagement was 109 days (SD = 67.6); 16.7% (n = 37) enrolled during the first trimester, 37.6% (n = 83) in the second trimester, and 45.7% (n = 101) in the third trimester. Of the 221 women engaged, 45.2% (n = 100) remained engaged in the case of management at the time of data collection, and 40% (n = 89) remained engaged in MAT at the time of data collection. Twenty- five percent (n = 25) of mothers who graduated sustained engagement in MAT. Of 225 infants 28.9% (n = 65) had a positive NAS status, mean birth weight was 6.5 lbs. (SD = 19.3); mean gestational age was 38.3 weeks (SD = 19.3) and mean length of stay was 8.19 days (SD = 9.8). This study's findings identified that engaging mothers during pregnancy in a program designed to meet their unique challenges positively impacts both the mother and infant outcomes, regardless of their timing.

Keywords: intensive case management, neonatal abstinence syndrome, opioid addiction, opioid crisis, opioid use in pregnant women, postpartum addiction

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Authors: Mandana Karimi, Martha McMahon

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One of the most important consequences of water scarcity worldwide is the increase in conflicts over water issues, reduced access to clean water, food shortages, energy shortages, and reduced economic development. The extreme weather conditions in British Columbia are because of climate change, which is leading to water scarcity becoming a serious issue affecting British Columbians, aquatic ecosystems, the BC water policy, agriculture, and the economy. In light of climate change and water stress, the British Columbia government introduced a new water legislation in 2016 named the Water Sustainability Act to manage water resources in British Columbia. So, this study aimed to present a deep understanding emanating from the political and social dimensions of the new water policy in BC in the agriculture sector and which sociological paradigm governs the current water policy (WSA) in BC. Policy analysis based on the water problem representation approach was used to present the problem and solutions identified by the water policy in the agricultural sector in BC. The results of the policy analysis highlighted that the Water Sustainability Act is governed by a positivist and modernist approach because the groundwater license is the measurable situation to access the adequate quantity of water for the farmers. In addition, by the positivist paradigm water resources are conceptualized as a commodity to be bought and sold. Under the positivist approach, the measurable parameter of groundwater is also applied based on the top-down approach for water management to show the use of water resources for economic development. In addition, the findings of the policy analysis suggest that alternative paradigms, such as relational ontology, ecofeminism, and indigenous knowledge, could be applied in introducing water policies to shift from the positivist or modernist paradigm. These new paradigms present the potential for environmental policies like the Water Sustainability Act, based on partnership, and collaboration and with an explicit emphasis on protecting water for nature.

Keywords: water governance, Water Sustainability Act, water policy, small-scale farmer, policy analysis

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Authors: Mina Sarabi, Dariush Sattarzadeh, Mitra Asadollahi Oula

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In the old days, gardens reflect the identity and culture of each country. Persian garden in urban planning and architecture has a high position and it is a kind of paradise in Iranian opinion. But nowadays, the gardens were replaced with parks and urban open spaces. On the other hand, due to the industrial development of cities and increasing air pollution in urban environments, living in this spaces make problem for people. And improving ecological conditions will be felt more than ever. The purposes of this study are identification and reproduction of Persian garden pattern and adaptation of it with sustainability features in green spaces in contemporary cities and developing meaningful green spaces instead of designing aimless spaces in urban environment. The research method in this article is analytical and descriptive. Studying and collecting information about Iranian garden pattern is referring to library documents, articles and analysis case studies. The result reveals that Persian garden was the main factor the bond between man and nature. But in the last century, this relationship is in trouble. It has a significant impact in reducing the adverse effects of urban air pollution, noise and etc as well. Nowadays, recreated pattern of Iranian gardens in urban green spaces not only keep Iranian identity for future generations but also, using the principles of sustainability can play an important role in sustainable development and quality space of a city.

Keywords: green open spaces, nature, Persian garden, urban sustainability

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Authors: Megan E. Davies

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The effects of climate change impact the environment and our physical health but also demonstrate a growing risk factor for Canadians’ individual and collective mental health. Past research and expert predictions are discussed while exploring the connection between mental health concerns and climate change consequences, resulting in a call to action for psychological sciences to be integrated into solution planning. With the direct and indirect effects of climate change steadily increasing, political and legal aspects of sustainability, as well as the repercussions for mental health being seen in Canada regarding climate change, are investigated. An interdisciplinary perspective for reviewing the challenges of climate change is applied in order to propose a realistic plan for how policymakers and mental health professionals can work together moving forward in applying interventions that mediate against the effects of climate change on Canadians’ mental health.

Keywords: climate change, mental health, policy change, solution planning, sustainability

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Authors: Zhiqiang Zhu, Khalegh Barati, Xuesong Shen

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Due to the energy consumption caused by the construction industry, the public is paying more and more attention to the sustainability of the buildings. With the advancement of research on recycled aggregates, it has become possible to replace natural aggregates with recycled aggregates and to achieve a reduction in energy consumption of materials during construction. The purpose of this paper is to quantitatively compare the emergy consumption of natural aggregate concrete (NAC) and recycled aggregate concrete (RAC). To do so, the emergy analysis method is adopted. Using this technique, it can effectively analyze different forms of energy and substance. The main analysis object is the direct and indirect emergy consumption of the stages in concrete production. Therefore, for indirect energy, consumption of production machinery and transportation vehicle also need to be considered. Finally, the emergy values required to produce the two concrete types are compared to analyze whether the RAC can reduce emergy consumption.

Keywords: sustainable construction, NAC, RAC, emergy, concrete

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Authors: Sushma Tejwani, Shoruba Dinakaran, Rupa Rokhade, K. Bhujang Shetty

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Introduction and aim: One of the major causes for failure of trabeculectomy is fibrosis and scarring of subconjunctival tissue around the bleb, and hence intra operative usage of anti-fibrotic agents like Mitomycin C (MMC) has become very popular. However, the long term effects of MMC like thin, avascular bleb, hypotony, bleb leaks and late onset endophthalmitis cannot be ignored, and may preclude its usage in routine trabeculectomy. In this particular study we aim to study the outcomes of trabeculectomy with and without MMC in uncomplicated glaucoma patients. Methods: Retrospective study of series of patients that underwent trabeculectomy with or without cataract surgery in glaucoma department of a tertiary eye care centre by a single surgeon for primary open angle glaucoma (POAG), angle closure glaucoma (PACG), Pseudoexfoliation glaucoma (PXF glaucoma). Patients with secondary glaucoma, juvenile and congenital glaucoma were excluded; also patients undergoing second trabeculectomy were excluded. The outcomes were studied in terms of IOP control at 1 month, 6 months, and 1 year and were analyzed separately for surgical outcomes with and without MMC. Success was considered if IOP was < 16 mmHg on applanation tonometry. Further, the necessity of medication, 5 fluorouracil (5FU) postoperative injections, needling post operatively was noted. Results: Eighty nine patient’s medical records were reviewed, of which 58 patients had undergone trabeculectomy without MMC and 31 with MMC. Mean age was 62.4 (95%CI 61- 64), 34 were females and 55 males. MMC group (n=31): Preoperative mean IOP was 21.1mmHg (95% CI: 17.6 -24.6), and 22 patients had IOP > 16. Three out of 33 patients were on single medication and rests were on multiple drugs. At 1 month (n=27) mean IOP was 12.4 mmHg (CI: 10.7-14), and 31/33 had success. At 6 months (n=18) mean IOP was 13mmHg (CI: 10.3-14.6) and 16/18 had good outcome, however at 1 year only 11 patients were available for follow up and 91% (10/11) had success. Overall, 3 patients required medication and one patient required postoperative injection of 5 FU. No MMC group (n=58): Preoperative mean IOP was 21.9 mmHg (CI: 19.8-24.2), and 42 had IOP > 16 mmHg. 12 out of 58 patients were on single medication and rests were on multiple drugs. At 1 month (n=52) mean IOP was14.6mmHg (CI: 13.2-15.9), and 45/ 58 had IOP < 16mmHg. At 6 months (n=31) mean IOP was 13.5 mmHg (CI: 11.9-15.2) and 26/31 had success, however at 1 year only 23 patients came for follow up and of these 87% (20/23) patients had success. Overall, 1 patient required needling, 5 required 5 FU injections and 5 patients required medication. The success rates at each follow up visit were not significantly different in both the groups. Conclusion: Intra-operative MMC usage may not be required in all patients undergoing trabeculectomy, and the ones without MMC also have fairly good outcomes in primary glaucoma.

Keywords: glaucoma filtration surgery, mitomycin C, outcomes of trabeculectomy, wound modulation

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Authors: Hazal Yılmaz, Hale Karakaş

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In the scope of the study, it is aimed to investigate and review the performance of denim fabrics that are foam washed. Foam washing was compared as an alternative to stone washing in terms of sustainability and performance parameters. For this purpose, seven different denim fabrics, which are both stone washed and foam washed separately in 3 different washing durations (30-60-90 mins), were compared. In the study, the same fabrics were processed with both foam and stone separately. The washing process steps were reviewed, and their water consumption values were compared. After washing, a total of 42 fabric samples were obtained, and tensile strength, tear strength, abrasion, weight loss after abrasion, rubbing fastness, color fastness tests were carried out on the fabric samples. The obtained test results were reviewed and evaluated. As a result of tests, it has been observed that the performance of foam washed fabrics in terms of tensile, tear strength and rubbing fastness test results are better than stone washed fabrics, and it has been seen that foam washed fabrics' color fastness test results are as stone washed. As a result of all these tests, it can be seen that foam washing is an alternative to stone washing due to its performance parameters and its sustainability performance with less water usage.

Keywords: denim fabrics, denim washing, foam washing, performance properties, stone washing, sustainability

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Authors: Peter J. Fusco, Dave M. Mathew, Chris Mathew, Kenneth H. Levy, Kathryn S. Varghese, Stephanie Salazar-Restrepo, Serena M. Mathew, Sofia Khaja, Eamon Vega, Mia Polizzi, Alyssa Mullane, Adham Ahmed

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Background: Laparoscopic (LS) removal of neuroblastomas in children has been reported to offer favorable outcomes compared to the conventional open thoracotomy (OT) procedure. Critical perioperative measures such as blood loss, operative time, length of stay, and time to postoperative chemotherapy have all supported laparoscopic use rather than its more invasive counterpart. Herein, a pairwise meta-analysis was performed comparing perioperative outcomes between LS and OT in thoracoabdominal neuroblastoma cases. Methods: A comprehensive literature search was performed on PubMed, Ovid EMBASE, and Scopus databases to identify studies comparing the outcomes of pediatric patients with thoracoabdominal neuroblastomas undergoing resection via OT or LS. After deduplication, 4,227 studies were identified and subjected to initial title screening with exclusion and inclusion criteria to ensure relevance. When studies contained overlapping cohorts, only the larger series were included. Primary outcomes include estimated blood loss (EBL), hospital length of stay (LOS), and mortality, while secondary outcomes were tumor recurrence, post-operative complications, and operation length. The “meta” and “metafor” packages were used in R, version 4.0.2, to pool risk ratios (RR) or standardized mean differences (SMD) in addition to their 95% confidence intervals in the random effects model via the Mantel-Haenszel method. Heterogeneity between studies was assessed using the I² test, while publication bias was assessed via funnel plot. Results: The pooled analysis included 209 patients from 5 studies (141 OT, 68 LS). Of the included studies, 2 originated from the United States, 1 from Toronto, 1 from China, and 1was from a Japanese center. Mean age between study cohorts ranged from 2.4 to 5.3 years old, with female patients occupying between 30.8% to 50% of the study populations. No statistically significant difference was found between the two groups for LOS (SMD -1.02; p=0.083), mortality (RR 0.30; p=0.251), recurrence(RR 0.31; p=0.162), post-operative complications (RR 0.73; p=0.732), or operation length (SMD -0.07; p=0.648). Of note, LS appeared to be protective in the analysis for EBL, although it did not reach statistical significance (SMD -0.4174; p= 0.051). Conclusion: Despite promising literature assessing LS removal of pediatric neuroblastomas, results showed it was non-superior to OT for any explored perioperative outcomes. Given the limited comparative data on the subject, it is evident that randomized trials are necessary to further the efficacy of the conclusions reached.

Keywords: laparoscopy, neuroblastoma, thoracoabdominal, thoracotomy

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Authors: Sally Naji, Julie Gwilliam

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Climate change remains a challenging matter for the human and the built environment in the 21st century, where the need to consider adaptation to climate change in the development process is paramount. However, there remains a lack of information regarding how we should prepare responses to this issue, such as through developing organized and sophisticated tools enabling the adaptation process. This study aims to build a systematic framework approach to investigate the potentials that Neighborhood Sustainability Assessment tools (NSA) might offer in enabling both the analysis of the emerging adaptive capacity to climate change. The analysis of the framework presented in this paper aims to discuss this issue in three main phases. The first part attempts to link sustainability and climate change, in the context of adaptive capacity. It is argued that in deciding to promote sustainability in the context of climate change, both the resilience and vulnerability processes become central. However, there is still a gap in the current literature regarding how the sustainable development process can respond to climate change. As well as how the resilience of practical strategies might be evaluated. It is suggested that the integration of the sustainability assessment processes with both the resilience thinking process, and vulnerability might provide important components for addressing the adaptive capacity to climate change. A critical review of existing literature is presented illustrating the current lack of work in this field, integrating these three concepts in the context of addressing the adaptive capacity to climate change. The second part aims to identify the most appropriate scale at which to address the built environment for the climate change adaptation. It is suggested that the neighborhood scale can be considered as more suitable than either the building or urban scales. It then presents the example of NSAs, and discusses the need to explore their potential role in promoting the adaptive capacity to climate change. The third part of the framework presents a comparison among three example NSAs, BREEAM Communities, LEED-ND, and CASBEE-UD. These three tools have been selected as the most developed and comprehensive assessment tools that are currently available for the neighborhood scale. This study concludes that NSAs are likely to present the basis for an organized framework to address the practical process for analyzing and yet promoting Adaptive Capacity to Climate Change. It is further argued that vulnerability (exposure & sensitivity) and resilience (Interdependence & Recovery) form essential aspects to be addressed in the future assessment of NSA’s capability to adapt to both short and long term climate change impacts. Finally, it is acknowledged that further work is now required to understand impact assessment in terms of the range of physical sectors (Water, Energy, Transportation, Building, Land Use and Ecosystems), Actor and stakeholder engagement as well as a detailed evaluation of the NSA indicators, together with a barriers diagnosis process.

Keywords: adaptive capacity, climate change, NSA tools, resilience, sustainability

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Authors: Zainab A. Alaghbri, Labiba A., Esam A.

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Tuberculosis (TB) is the fourth leading cause of death in Yemen and is considered a major priority by the Ministry of Public Health. The war in Yemen has led to the emergence of one of the worst humanitarian crises in the world. These circumstances may lead to exacerbate the situation of tuberculosis. This study aims to describe the trend and incidence of TB in north and east governorates, Yemen 2019-2021 and provide recommendations for interventions. A descriptive analysis was conducted during July to September 2022. Data of TB cases were obtained from the national tuberculosis program as soft copy. The Data included the TB case collected and diagnosed during 2019-2021. The data contains the following variables: Sex, age, governorates, smear-positive cases, extra-pulmonary cases, and treatment outcomes. 16791 TB cases were notified for an overall case notification rate 65.5/100000 for all forms (smear positive and Extra-pulmonary), There was a slightly declined in 2020 and 2021 by 1%. Both the pulmonary smear positive and Extra pulmonary rates were slightly decreased from 8.8 to 7.7 and 13.5 to 12.8 / 100, 000 populations respectively. For Tuberculosis cases by type of patient, the incidence of extra-pulmonary was the highest (12,9, 11.3 and 12,2/100000) over the three years. However, the incidence of pulmonary failure was the lowest. The majority of cases were in the age group 25-34. The overall treatment success rate for smear-positive patients was 88%. Of the 627 patients with documented unsuccessful outcomes (e.g., failure, death, and default), 165 (23%) died, 52 (8.3%) failed treatment, and 410 (65%) defaulted. Overall, the magnitude of tuberculosis decreased over the periods reviewed. The proportion of Extra-pulmonary TB was the highest. The success rate achieved after treatment was below the levels established by the WHO End Tuberculosis Strategy (90%). Failure to complete treatment may be responsible for the low success rate. Monitoring and addressing the risk factors that were associated with treatment outcomes and duration may help improve the likelihood of achieving favorable outcomes among cases of smear-positive pulmonary TB.

Keywords: tuberculosis, trend, incidence, yemen

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Authors: Frezer Alem Kebede

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The notion of viewing ICT as merely support for the business process has shifted towards viewing ICT as a critical business enabler. As such, the need for ICT devices has increased, contributing to high electronic equipment acquisition and disposal. Hence, its use and disposal must be seen in light of environmental sustainability, i.e., in terms of green use and disposal. However, there are limited studies on green Use and Disposal framework to be used as guiding lens by organizations in developing countries. And this study endeavors to address that need taking one of the largest multinational ICT intensive company in the country. The design and development of this framework passed through several stages, initially factors affecting green use and disposal were identified after quantitative and qualitative data analysis then there were multiple brainstorming sessions for the design enhancement as participative modelling was employed. Given the difference in scope and magnitude of the challenges identified, the proposed framework approaches green use and disposal in four imperatives; strategically, tactically, operationally and through continuous improvement.

Keywords: energy efficiency, green disposal, green ICT, green use, green use and disposal framework, sustainability

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Authors: Yi-Ting Chen, Yu-Fang Huang, Pei-Wei Wang, Hai-Wei Liang, Chun-Hao Lai, Mei-Lien Chen

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Background: Bisphenol A (BPA) is commonly used in consumer products, such as inner coatings of cans and polycarbonated bottles. BPA is considered to be an endocrine disrupting substance (EDs) that affects normal human hormones and may cause adverse effects on human health. Pregnant women and fetuses are susceptible groups of endocrine disrupting substances. Prenatal exposure to BPA has been shown to affect the fetus through the placenta. Therefore, it is important to evaluate the potential health risk of fetal exposure to BPA during pregnancy. The aims of this study were (1) to determine the urinary concentration of BPA in pregnant women, and (2) to investigate the association between BPA exposure during pregnancy and birth outcomes. Methods: This study recruited 117 pregnant women and their fetuses from 2012 to 2014 from the Taiwan Maternal- Infant Cohort Study (TMICS). Maternal urine samples were collected in the third trimester and questionnaires were used to collect socio-demographic characteristics, eating habits and medical conditions of the participants. Information about birth outcomes of the fetus was obtained from medical records. As for chemicals analysis, BPA concentrations in urine were determined by off-line solid-phase extraction-ultra-performance liquid chromatography coupled with a Q-Tof mass spectrometer. The urinary concentrations were adjusted with creatinine. The association between maternal concentrations of BPA and birth outcomes was estimated using the logistic regression model. Results: The detection rate of BPA is 99%; the concentration ranges (μg/g) from 0.16 to 46.90. The mean (SD) BPA levels are 5.37(6.42) μg/g creatinine. The mean ±SD of the body weight, body length, head circumference, chest circumference and gestational age at birth are 3105.18 ± 339.53 g, 49.33 ± 1.90 cm, 34.16 ± 1.06 cm, 32.34 ± 1.37 cm and 38.58 ± 1.37 weeks, respectively. After stratifying the exposure levels into two groups by median, pregnant women in higher exposure group would have an increased risk of lower body weight (OR=0.57, 95%CI=0.271-1.193), smaller chest circumference (OR=0.70, 95%CI=0.335-1.47) and shorter gestational age at birth newborn (OR=0.46, 95%CI=0.191-1.114). However, there are no associations between BPA concentration and birth outcomes reach a significant level (p < 0.05) in statistics. Conclusions: This study presents prenatal BPA profiles and infants in northern Taiwan. Women who have higher BPA concentrations tend to give birth to lower body weight, smaller chest circumference or shorter gestational age at birth newborn. More data will be included to verify the results. This report will also present the predictors of BPA concentrations for pregnant women.

Keywords: bisphenol A, birth outcomes, biomonitoring, prenatal exposure

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Authors: Peter Park, Alfonso Ayala, Douglas Saeks, Jordan Miller, Carmen Flores, Karen Nelson

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Introduction Hip fractures account for more than 300,000 hospital admissions every year. Many present as fragility fractures in geriatric patients with multiple medical comorbidities. Standardized protocols for the multidisciplinary management of this patient population have been shown to improve patient outcomes. A hip fracture protocol was implemented at a Level I Trauma center with a focus on pre-operative medical optimization and early surgical care. This study evaluates the efficacy of that protocol, including the early transition period. Methods A retrospective review was performed of all patients ages 60 and older with isolated hip fractures who were managed surgically between 2020 and 2022. This included patients 1 year prior and 1 year following the implementation of a hip fracture protocol at a Level I Trauma center. Results 530 patients were identified: 249 patients were treated before, and 281 patients were treated after the protocol was instituted. There was no difference in mean age (p=0.35), gender (p=0.3), or Charlson Comorbidity Index (p=0.38) between the cohorts. Following the implementation of the protocol, there were observed increases in time to surgery (27.5h vs. 33.8h, p=0.01), hospital length of stay (6.3d vs. 9.7d, p<0.001), and ED LOS (5.1h vs. 6.2h, p<0.001). There were no differences in in-hospital mortality (2.01% pre vs. 3.20% post, p=0.39) and complication rates (25% pre vs 26% post, p=0.76). A trend towards improved outcomes was seen after the early transition period but failed to yield statistical significance. Conclusion Early medical management and surgical intervention are key determining factors affecting outcomes following fragility hip fractures. The implementation of a hip fracture protocol at this institution has not yet significantly affected these parameters. This could in part be due to the restrictions placed at this institution during the COVID-19 pandemic. Despite this, the time to OR pre-and post-implementation was quicker than figures reported elsewhere in literature. Further longitudinal data will be collected to determine the final influence of this protocol. Significance/Clinical Relevance Given the increasing number of elderly people and the high morbidity and mortality associated with hip fractures in this population finding cost effective ways to improve outcomes in the management of these injuries has the potential to have enormous positive impact for both patients and hospital systems.

Keywords: hip fracture, geriatric, treatment algorithm, preoperative optimization

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Authors: James Alberto Ortega Morales, Nelson Andrés Martínez Marín

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The bulding industry is one of the most important sectors all around the world in terms of contribution to index like GDP and labor. On the other hand, it is a major contributor to Greenhouse Gases (GHG) and waste generation contributing to global warming. In this sense, it is necessary to establish sustainable practices both from the strategic point of view to the operations point of view as well in all business and industries. Business models don’t scape to this reality attending it´s mediator role between strategy and operations. Business models can turn from the traditional practices searching economic benefits to sustainable bussines models that generate both economic value and value for society and the environment. Recent advances in the analysis of sustainable business models find different classifications that allow finding potential triple bottom line (economic, social and environmental) solutions applicable in every business sector. Into the metioned Advances have been identified, 11 groups and 45 patterns of sustainable business models have been identified; such patterns can be found either in the business models as a whole or found concurrently in their components. This article presents the analysis of a case study, seeking to identify the components and elements that are part of it, using the ECO CANVAS conceptual model. The case study allows showing the concurrent existence of different patterns of business models for sustainability empirically, serving as an example and inspiration for other Latin American companies interested in integrating sustainability into their new and existing business models.

Keywords: sustainable business models, business sustainability, business model patterns, case study, construction industry

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Authors: Maha Salah Abdullah Ismail, Mahmoud M. Alsagheir, Mohammed Salah Abd Allah

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Acute respiratory distress syndrome (ARDS) is characterized by permeability pulmonary edema and refractory hypoxemia. Lung-protective ventilation is still the key of better outcome in ARDS. Prone position reduces the trans-pulmonary pressure gradient, recruiting collapsed regions of the lung without increasing airway pressure or hyperinflation. Prone ventilation showed improved oxygenation and improved outcomes in severe hypoxemic patients with ARDS. This study evaluates the effect of prone positioning on mechanically ventilated patients with ARDS. A quasi-experimental design was carried out at Critical Care Units, on 60 patients. Two tools were utilized to collect data; Socio demographic, medical and clinical outcomes data sheet. Results of the present study indicated that prone position improves oxygenation in patients with severe respiratory distress syndrome. The study recommended that use prone position in patients with severe ARDS, as early as possible and for long sessions. Also, replication of this study on larger probability sample at the different geographical location is highly recommended.

Keywords: acute respiratory distress syndrome, critical care, mechanical ventilation, prone position

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Authors: Gholamhassan Kakha, Mohsen Jami, Daniel Alex Merino Natorce

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Sustainable development refers to the creation of a balance between the development and the environment too; it consists of three key principles namely environment, society and economy. These three parameters are related to each other and the imbalance occurs in each will lead to the disparity of the other parts. Mining is one of the most important tools of the economic growth and social welfare in many countries. Meanwhile, assessment of the environmental impacts has directed to the attention of planners toward the natural environment of the areas surrounded by mines and allowing for monitoring and controlling of the current situation by the designers. In this look upon, a semi-quantitative model using a matrix method is presented for assessing the environmental impacts in the BOOG Granite Mine located in Sistan and Balouchestan, one of the provinces of Iran for determining the effective factors and environmental components. For accomplishing this purpose, the initial data are collected by the experts at the next stage; the effect of the factors affects each environmental component is determined by specifying the qualitative viewpoints. Based on the results, factors including air quality, ecology, human health and safety along with the environmental damages resulted from mining activities in that area. Finally, the results gained from the assessment of the environmental impact are used to evaluate the sustainability by using Philips mathematical model. The results show that the sustainability of this area is weak, so environmental preventive measures are recommended to reduce the environmental damages to its components.

Keywords: sustainable development, environmental impacts' assessment, BOOG granite, Philips mathematical model

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Authors: Elif Berna Var

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Cultural, physical, socio-economic, or politic changes occurred in urban areas might be resulted in the decaying period which may cause social problems. As a solution to that, urban renewal projects have been used in European countries since World War II whereas they have gained importance in Turkey after the 1980s. The first attempts were mostly related to physical or economic aspects which caused negative effects on social pattern later. Thus, social concerns have also started to include in renewal processes in developed countries. This integrative approach combining social, physical, and economic aspects promotes creating more sustainable neighbourhoods for both current and future generations. However, it is still a new subject for developing countries like Turkey. Concentrating on Trabzon-Turkey, this study highlights the importance of socially sustainable urban renewal processes especially in historical neighbourhoods where protecting the urban identity of the area is vital, as well as social structure, to create sustainable environments. Being in the historic city centre and having remarkable traditional houses, Ortahisar is an important image for Trabzon. Because of the fact that architectural and historical pattern of the area is still visible but need rehabilitations, it is preferred to use 'urban rehabilitation' as a way of urban renewal method for this study. A project is developed by the local government to create a secondary city centre and a new landmark for the city. But it is still ambiguous if this project can provide social sustainability of area which is one of the concerns of the research. In the study, it is suggested that social sustainability of an area can be achieved by several factors. In order to determine the factors affecting the social sustainability of an urban rehabilitation project, previous studies have been analysed and some common features are attempted to define. To achieve this, firstly, several analyses are conducted to find out social structure of Ortahisar. Secondly, structured interviews are implemented to 150 local people which aims to measure satisfaction level, awareness, the expectation of them, and to learn their demographical background in detail. Those data are used to define the critical factors for a more socially sustainable neighbourhood in Ortahisar. Later, the priority of those factors is asked to 50 experts and 150 local people to compare their attitudes and to find common criterias. According to the results, it can be said that social sustainability of Ortahisar neighbourhood can be improved by considering various factors like quality of urban areas, demographical factors, public participation, social cohesion and harmony, proprietorial factors, facilities of education and employment. In the end, several suggestions are made for Ortahisar case to promote more socially sustainable urban neighbourhood. As a pilot study highlighting the importance of social sustainability, it is hoped that this attempt might be the contributory effect on achieving more socially sustainable urban rehabilitation projects in Turkey.

Keywords: urban rehabilitation, social sustainability, Trabzon, Turkey

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Authors: Xi Vivien Wu, Emily Neo Kim Ang, Yi Jung Tung, Wenru Wang

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Background and Objective: The increase in life expectancy and emphasis on self-reliance for the older adults are global phenomena. As such, lifelong learning in the community is considered a viable means of promoting successful and active aging. This systematic review aims to examine various lifelong learning programs for community-dwelling older adults and to synthesize the contents and outcomes of these lifelong learning programs. Methods: A systematic search was conducted in July to December 2016. Two reviewers were engaged in the process to ensure creditability of the selection process. Narrative description and analysis were applied with the support of a tabulation of key data including study design, interventions, and outcomes. Results: Eleven articles, which consisted of five randomized controlled trials and six quasi-experimental studies, were included in this review. Interventions included e-health literacy programs with the aid of computers and the Internet (n=4), computer and Internet training (n=3), physical fitness programs (n=2), music program (n=1), and intergenerational program (n=1). All studies used objective measurement tools to evaluate the outcomes of the study. Conclusion: The systematic review indicated lifelong learning programs resulted in positive outcomes in terms of physical health, mental health, social behavior, social support, self-efficacy and confidence in computer usage, and increased e-health literacy efficacy. However, the lifelong learning programs face challenges such as funding shortages, program cuts, and increasing costs. A comprehensive lifelong learning program could be developed to enhance the well-being of the older adults at a more holistic level. Empirical research can be done to explore the effectiveness of this comprehensive lifelong learning program.

Keywords: community-dwelling older adults, e-health literacy program, lifelong learning program, the wellbeing of the older adults

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Authors: David Lynch, Jake Madden

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There exists a body of literature that reports on the many benefits of partnerships between universities and schools, especially in terms of teaching improvement and school reform. This is because such partnerships can build significant teaching capital, by deepening and expanding the skillsets and mindsets needed to create the connections that support ongoing and embedded teacher professional development and career goals. At the same time, this literature is critical of such initiatives when the partnership outcomes are short- term or one-sided, misaligned to fundamental problems, and not expressly focused on building the desired teaching capabilities. In response to this situation, research conducted by Professor David Lynch and his TeachLab research team, has begun to shed light on the strengths and limitations of school/university partnerships, via the identification of key conceptual elements that appear to act as critical partnership success factors. These elements are theorised as an inter-play between professional knowledge acquisition, readiness, talent management and organisational structure. However, knowledge of how these elements are established, and how they manifest within the school and its teaching workforce as an overall system, remains incomplete. Therefore, research designed to more clearly delineate these elements in relation to their impact on school/university partnerships is thus required. It is within this context that this paper reports on the development and testing of a Professional Learning (PL) model for schools and their teachers that incorporates school-university research partnering within a systematic, whole-of-school PL strategy that is underpinned and structured by a micro-credentialing (MC) regime. MC involves learning a narrow-focused certificate (a micro-credential) in a specific topic area (e.g., 'How to Differentiate Instruction for English as a second language Students') and embedded in the teacher’s day-to-day teaching work. The use of MC is viewed as important to the efficacy and sustainability of teacher PL because it (1) provides an evidence-based framework for teacher learning, (2) has the ability to promote teacher social capital and (3) engender lifelong learning in keeping professional skills current in an embedded and seamless to work manner. The associated research is centred on a primary school in Australia (P-6) that acted as an arena to co-develop, test/investigate and report on outcomes for teacher PL that uses MC to support a whole-of-school partnership with a university.

Keywords: teaching improvement, teacher professional learning, talent management, education partnerships, school-university research

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Authors: Janet Kaningen, Richard N. Kaningen, Jonas Kaningen

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This paper aims to discover the best ways to improve production efficiency, cost efficiency, community cohesion, and long-term sustainability in Ghana's housing delivery. Advanced Construction Technologies (ACTs) are set to become the sustainable mainstay of the construction industry due to the demand for innovative housing solutions. Advances in material science, building component production, and assembly technologies are leading to the development of next-generation materials such as polymeric-fiber-based products, light-metal alloys, and eco-materials. Modular housing construction has become more efficient and cost-effective than traditional building methods and is becoming increasingly popular for commercial, industrial, and residential projects. Effective project management and logistics will be imperative in the future speed and cost of modular construction housing.

Keywords: technology blending, sustainability, housing, Ghana

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Authors: O. Onigbogi, M. Onigbogi Jr., O. Ojo

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Background: The advances in mobile telephone technology has led to a rise in its use globally which has improved service delivery, empowered businesses and changed the way people access information. The practice of many health professionals has also been affected by the information and communications technology (ICT) revolution because they have better access to information. This study was conducted to assess the willingness to participate in mobile technology interventions to improve pregnancy outcomes in Lagos, Nigeria. Materials and Methods: A total of 238 respondents completed self-administered questionnaires. SPSS version 18 data editor was used to analyze data. Univariate odds ratios and 95% confidence intervals (95 % CI) were used to evaluate the correlates of Willingness to Use (WTU) mobile phones to receive health messages during pregnancy. Results: A total of 107 women (45% of the respondents) reported that they will be willing to receive health-related information on their phones during pregnancy. Greater willingness was associated with higher education (OR = 1.25, 95% CI: 1.13–1.53), involvement with community volunteer organizations (OR = 1.25, 95% CI: 1.05–1.52), monetary incentives (OR = 1.37, 95% CI: 1.14–1.45) and nulliparity (OR = 1.39, 95% CI: 1.02–1.42). Decreased willingness was associated with concerns about wrong interpretation of information (OR = 0.42, 95% CI: 0.21–0.54), poor mobile telephone service by providers (OR = 0.61, 95% CI: 0.52–0.78), increase in number of messages (OR = 0.78, 95% CI: 0.53–0.76). Conclusion: The level of WTU recorded indicates that much work still needs to be done before this novel approach could be used adopted in delivering health-related information. Incentives for would-be subjects should also be a part of the planning to encourage greater participation.

Keywords: mobile, outcomes, pregnancy, technology, telephone

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Authors: Zainur Rahman

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Meaningful work is the topic that will be discussed in this article, especially in changing period. It has an important role because by reaching meaningful work, it will drive to be positive in the workplace. Therefore, task performance will be increased and cynicism about organizational change (CAOC) will be reduced. Moreover, it is influenced by situational factor, which is transformational leadership. In this conceptual paper, the author discusses how the construct of meaningful work influenced by transformational leadership that will have impact on the follower’ work outcomes in the organizational change. It is proposed that the construct of meaningful work are susceptible with situational variable. Transformational leaders who are respectful on the process of humanizing the followers affect task performance and reduce CAOC in organizational change.

Keywords: transformational leadership, meaningful work, task performance, CAOC

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Authors: Bushra, Filza Akhtar

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As countries face increased pressure to address environmental issues and resource constraints, the need to implement sustainable waste management strategies grows. This research study investigates the concept of circular economy principles in the context of municipal waste management as a tool for achieving sustainability goals. Municipalities can reduce environmental impacts, conserve resources, and promote economic development by switching from traditional linear waste disposal prototypes to circular approaches prioritizing waste minimization, reuse, recycling, and resource recovery. Drawing on case studies and best practices worldwide, this study investigates the potential benefits, obstacles, and opportunities of incorporating circular economy principles into waste management methods. It also talks about the role of regulatory frameworks, technology advances, and stakeholder participation in driving the transformation.

Keywords: sustainable, waste, management, circular economy

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Authors: Jeremy Faludi, Zhongyin Hu, Shahd Alrashed, Christopher Braunholz, Suneesh Kaul, Leulekal Kassaye

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Environmental impacts of six 3D printers using various materials were compared to determine if material choice drove sustainability, or if other factors such as machine type, machine size, or machine utilization dominate. Cradle-to-grave life-cycle assessments were performed, comparing a commercial-scale FDM machine printing in ABS plastic, a desktop FDM machine printing in ABS, a desktop FDM machine printing in PET and PLA plastics, a polyjet machine printing in its proprietary polymer, an SLA machine printing in its polymer, and an inkjet machine hacked to print in salt and dextrose. All scenarios were scored using ReCiPe Endpoint H methodology to combine multiple impact categories, comparing environmental impacts per part made for several scenarios per machine. Results showed that most printers’ ecological impacts were dominated by electricity use, not materials, and the changes in electricity use due to different plastics was not significant compared to variation from one machine to another. Variation in machine idle time determined impacts per part most strongly. However, material impacts were quite important for the inkjet printer hacked to print in salt: In its optimal scenario, it had up to 1/38th the impacts coreper part as the worst-performing machine in the same scenario. If salt parts were infused with epoxy to make them more physically robust, then much of this advantage disappeared, and material impacts actually dominated or equaled electricity use. Future studies should also measure DMLS and SLS processes / materials.

Keywords: 3D printing, additive manufacturing, sustainability, life-cycle assessment, design for environment

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Authors: Mohammed Alharbi, Clare Wood, Vasileios Samaras

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Sustainability leadership is a controversial topic, particularly in the engineering context. The theoretical and practical technical focus of the engineering profession impacts our lives. Technologically, engineers significantly contribute to our modern civilization. Industrial revolutions are among the top engineering accomplishments that have contributed to the flourishing of our life. However, engineers have not always received the credit they deserve; instead, they have been blamed for the advent of various global issues, among them the global warming phenomena that are believed to be a result of the industrial revolutions. Global challenges demand engineers demonstrate more than their technical skills for effective contribution to a sustainable future. As a result, engineering leadership has emerged as a new research field. Sustainable manufacturing is a cornerstone for sustainable development. Investigating the change to more sustainable manufacturing practices is a significant issue for all, and even more in the field of engineering leadership. Engineers dominate the manufacturing industry; however, one of the main criticism of engineers is the lack of leadership skills. The literature on engineering leadership has not highlighted enough the engineers' leadership ability in leading sustainable manufacturing. Since we are at the cusp of a new industrial revolution -Industry 4.0, it is vital to investigate the ability of engineers to lead the industry towards a sustainable future. The primary purpose of this paper is to evaluate engineers' sustainability leadership competencies utilizing The Cambridge University Behavioral Competency Model. However, the practical application of the Cambridge model is limited due to the absence of a reliable measurement tool. Therefore, this study developed a valid and reliable survey instrument tool compatible with the Cambridge model as a secondary objective. More than 300 Saudi engineers from the manufacturing industry responded to an online questionnaire collected through the Qualtrics platform and analyzed using SPSS software. The findings provide a contemporary understanding of engineers' mindset related to sustainability leadership. The output of this research study could be valuable in designing effective engineering leadership programs in academia or industry, particularly for enhancing a sustainable manufacturing environment.

Keywords: engineer, leadership, manufacturing, sustainability

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Authors: Hui-Yi Wang, Shu-Mei Chen, Mei-Fang Liu

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Background and purpose: Providing clinical experience in medical education is an important discipline method where students can gradually apply their academic knowledge to clinical situations. The purpose of this study was to establish self-assessment questionnaires for students to assess their learning outcomes for two fields of physical therapy, orthopedic physical therapy, and pediatric physical therapy, in a clinical fieldwork course. Methods: The questionnaires were developed based on the core competence dimensions of the course. The content validity of the questionnaires was evaluated and established by expert meetings. Among the third-year undergraduate students who took the clinical fieldwork course, there were 49 students participated in this study. Teachers arranged for the students to study two professional fields, and each professional field conducted a three-week clinical lesson. The students filled out the self-assessment questionnaires before and after each three-week lesson. Results: The self-assessment questionnaires were established by expert meetings that there were six core competency dimensions in each of the two fields, with 20 and 21 item-questions, respectively. After each three-week clinical fieldwork, the self-rating scores in each core competency dimension were higher when compared to those before the course, indicating having better clinical abilities after the lessons. The best self-rating scores were the dimension of attitude and humanistic literacy, and the two lower scores were the dimensions of professional knowledge and skills and problem-solving critical thinking. Conclusions: This study developed questionnaires for clinical fieldwork courses to reflect students' learning outcomes, including the performance of professional knowledge, practice skills, and professional attitudes. The use of self-assessment of learning performance can help students build up their reflective competencies. Teachers can guide students to pay attention to the performance of abilities in each core dimension to enhance the effectiveness of learning through self-reflection and improvement.

Keywords: physical therapy, clinical fieldwork course, learning outcomes assessment, medical education, self-reflection ability

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Authors: Logaiswari Indiran, Noraindah Abdullah Fahim, Zainab Khalifah, Rohaizat Baharun, Kamariah Ismail

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Innovation capability is believed to give an important impact on organization’s sustainability and high performance. For instance, innovation capability able to transform technology into a specific organization’s operation, managerial, and transaction which increase organizational performance and economic growth of a country. In fact, research on high level of various antecedents has also shown positive impact on innovation capability. However, there are lacking studies explored on various kinds of antecedents which relate innovation capability’s role as mediator in the relationship. Thus, the purpose of this study is to specifically exhibit the mediation role of innovation capability between variety of antecedents and with different outcomes of an organization across industries. This study reviewed previous literature that has identified 'innovation capability' as mediator between the period of 2010 – 2016 and carries out a literature-based analysis of the findings in each article. From our review, innovation capability has been seen as a key role to mediate the relationship between independent variable and dependent variable in various industry. As the role of innovation capability as mediator is significant, new researchers should focus on varieties of independent variables. The review of this study will be useful for practitioners and researchers to understand and apply innovation capability as mediator to increase organizational success and innovativeness.

Keywords: innovation capability, mediator, organization performance, antecedents

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Authors: Julia Baker

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Development plays a major role in stopping biodiversity loss. But the ‘silo species’ protection of legislation (where certain species are protected while many are not) means that development can be ‘legally compliant’ and result in biodiversity loss. ‘Net Gain’ (NG) policies can help overcome this by making it an absolute requirement that development causes no overall loss of biodiversity and brings a benefit. However, offsetting biodiversity losses in one location with gains elsewhere is controversial because people suspect ‘offsetting’ to be an easy way for developers to buy their way out of conservation requirements. Yet the good practice principles (GPP) of offsetting provide several advantages over existing legislation for protecting biodiversity from development. This presentation describes the learning from implementing NG approaches based on GPP. It regards major upgrades of the UK’s transport networks, which involved removing vegetation in order to construct and safely operate new infrastructure. While low-lying habitats were retained, trees and other habitats disrupting the running or safety of transport networks could not. Consequently, achieving NG within the transport corridor was not possible and offsetting was required. The first ‘lessons learnt’ were on obtaining a commitment from business leaders to go beyond legislative requirements and deliver NG, and on the institutional change necessary to embed GPP within daily operations. These issues can only be addressed when the challenges that biodiversity poses for business are overcome. These challenges included: biodiversity cannot be measured easily unlike other sustainability factors like carbon and water that have metrics for target-setting and measuring progress; and, the mindset that biodiversity costs money and does not generate cash in return, which is the opposite of carbon or waste for example, where people can see how ‘sustainability’ actions save money. The challenges were overcome by presenting the GPP of NG as a cost-efficient solution to specific, critical risks facing the business that also boost industry recognition, and by using government-issued NG metrics to develop business-specific toolkits charting their NG progress whilst ensuring that NG decision-making was based on rich ecological data. An institutional change was best achieved by supporting, mentoring and training sustainability/environmental managers for these ‘frontline’ staff to embed GPP within the business. The second learning was from implementing the GPP where business partnered with local governments, wildlife groups and land owners to support their priorities for nature conservation, and where these partners had a say in decisions about where and how best to achieve NG. From this inclusive approach, offsetting contributed towards conservation priorities when all collaborated to manage trade-offs between: -Delivering ecologically equivalent offsets or compensating for losses of one type of biodiversity by providing another. -Achieving NG locally to the development whilst contributing towards national conservation priorities through landscape-level planning. -Not just protecting the extent and condition of existing biodiversity but ‘doing more’. -The multi-sector collaborations identified practical, workable solutions to ‘in perpetuity’. But key was strengthening linkages between biodiversity measures implemented for development and conservation work undertaken by local organizations so that developers support NG initiatives that really count.

Keywords: biodiversity offsetting, development, nature conservation planning, net gain

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Authors: Seng Sing Tan

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Clamping of the umbilical cord after birth is widely practiced as a part of labor management. Further improvements were proposed to produce a smaller, lighter and more comfortable clamp while still maintaining current standards of clamping. A detachable holder was also developed to facilitate the clamping process. This pilot study on the efficacy of the mini-clamp was conducted to evaluate a tightness of the seal and a firm grip of the clamp on the umbilical cord. The study was carried out at National University Hospital, using 5 sets of placental cord. 18 samples of approximate 10 cm each were harvested. The test results showed that the mini-clamp was able to stop the flow through the cord after clamping without rupturing the cord. All slip tests passed with a load of 0.2 kg. In the pressure testing, 30kPa of saline was exerted into the umbilical veins. Although there was no physical sign of fluid leaking through the end secured by the mini-clamp, the results showed the pressure was not able to sustain the pressure set during the tests. 12 out of the 18 test samples have more than 7% of pressure drop in 30 seconds. During the pressure leak test, it was observed on several samples that when pressurized, small droplets of saline were growing on the outer surface of the cord lining membrane. It was thus hypothesized that the pressure drop was likely caused by the perfusion of the injected saline through the Wharton’s jelly and the cord lining membrane. The average pressure in the umbilical vein is roughly 2.67kPa (20 mmHg), less than 10% of 30kPa (~225mmHg), set for the pressure testing. As such, the pressure set could be over-specified, leading to undesirable outcomes. The development of the mini-clamp was an attempt to increase the comfort of newly born babies while maintaining the usability and efficacy of hospital grade umbilical cord clamp. The pressure leak in this study would be unfair to fully attribute it to the design and efficacy of the mini-clamp. Considering the unexpected leakage of saline through the umbilical membrane due to over-specified pressure exerted on the umbilical veins, improvements can definitely be made to the existing experimental setup to obtain a more accurate and conclusive outcome. If proven conclusive and effective, the mini-clamp with a detachable holder could be a smaller and potentially cheaper alternative to existing umbilical cord clamps. In addition, future clinical trials could be conducted to determine the user-friendliness of the mini-clamp and evaluate its practicality in the clinical setting by labor ward clinicians. A further potential improvement could be proposed on the sustainability factor of the mini-clamp. A biodegradable clamp would revolutionise the industry in this increasingly environmentally sustainability world.

Keywords: leak test, mini-clamp, slip test, umbilical cord

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Authors: Reshma Raskar-Phule, Abhay Shinde, Manesh Konkani, Rohit Nighot, Shrirang Mahajan, Viraj Thorat

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Sustainability in construction projects can be considered from three dimensions - environment, economy and society. Key concepts of sustainable construction include the protection of the natural environment, choice of non-toxic materials, reduction and reuse of resources, waste minimization, and life cycle analysis. The present paper attempts to identify and analyze the use of sustainable construction materials for a new college hostel building in terms of sustainability development indices (SDIs). Low SDI materials, say as composite fiberglass reinforcement (SDI 4074.96), compressed earth blocks (SDI 0.47), and fiber-reinforced doors (SDI 0.13) are the proposed sustainable materials for the hostel building. Indian Green Building Certification (IGBC) is applied for the hostel building and it earns 5 points out of total 16 points for criterion 5 – Building Materials and Resources of IGBC.

Keywords: sustainable development, construction materials, IGBC, hostel building

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